A New Wartime President

America has been at war for a year. The current pandemic is far from over. In fact, it is possible parts of the country will go into lockdown again.

This week President Biden signed a dozen executive orders and invoked the Defense Production Act. This is a wartime law. It is designed to mobilize our country’s assets to protect our citizens. It was first enacted in 1950 for the Korean War then the Cold War. In 70 years, we’ve gone from nuclear warfare to biowarfare.

This act has been used several times this century. Obama invoked it in 2011 to protect our nation’s telecom assets from Chinese cyber attacks. Then Trump invoked the law in 2017 to protect our aerospace supply chain and again in 2020 to prepare for the worst case scenario with Covid-19. Trump’s Covid-19 actions were for agricultural products and to increase production of N-95 masks.

Now President Biden will invoke the same Act to increase supplies for vaccination. His goal is to vaccinate 100 million Americans in the first 100 days of his administration.

The Vaccine Rollout is Failing

America’s poor healthcare system is catching up with it. Our vaccine delivery is not a role model.

Texas is the first state to administer one million doses but has had technology failures since day one. Remember healthcare care providers are doctors, not tech nerds. These software systems can be out of date with incorrect patient data. And if a provider cannot administer vaccines in the first round to the right patients, they may not receive enough doses for the second round.

Not to mention that we don’t have vaccines for our healthcare workers eithers.

“Hard-hit Los Angeles County, the nation’s most populous county with 10 million residents, said it couldn’t immediately provide shots to the elderly because it had inoculated only about a quarter of its 800,000 health care workers.” - Associated Press

If you want to get vaccinated, I recommend visiting vaccines.gov to find the location nearest you. There’s a long waiting list.

Friedberg’s Rollout Strategy

We don’t go home in a wartime scenario.

There are too many disincentives in the system. For example New York state’s rollout strategy is upside down. Governor Cuomo has put out a million dollar fine for vaccine fraud yet at the same time will fine hospitals $100,000 if they don’t administer all their vaccine allocations.

“This is a management issue of the hospitals. They have to move the vaccine, and they have to move the vaccine faster,” Cuomo said.

This is a good example of poor politics. The Governor wants something done so quickly that he’s using fear to motivate the system. A million dollar fine is unnecessary. Everyone needs to get vaccinated.

David Friedberg, the CEO of Metromile, proposes we need to speed up vaccine delivery for the highest risk patients (+65 year olds) in the first 30 days. Then give nurses big cash incentives to administer as many vaccines as possible. 500,000 of the 3.8 million nurses in America can get the job done in 90 days.

Why does our rollout strategy matter? Vaccines outside of deep freeze can spoil since the drug can degrade quickly. Extra doses need to be given out. We do not need to take IDs or track patients. This creates friction. You see, in Israel they are giving out vaccines to every single person. No exceptions. This is why the country is leading the charts.

Worldwide Vaccine Rollout

Kill frictions. Unless it is a high risk patient, no one else needs priority. Everyone needs access to the vaccine now. The disincentives are killing Americans.

Pharmacies are front and center in this war

CVS and Walgreens can lead the vaccine rollout

CVS has over 10,000 locations in the U.S. Enough to be within walking distance of three quarters of the American population. Like McDonald’s there is a CVS around every corner.

CVS, Walgreens and other retail pharmacies can now use brick-and-mortar to their advantage. We can speed up vaccination delivery across the country if every American can access their local pharmacy. Grocery store pharmacies like Kroger are also being asked to help with the rollout.

Even Amazon, Uber and Lyft have all chipped in to provide last mile delivery. Lyft’s executive team met with President Biden last month to discuss vaccine-related transportation funds. Amazon is offering its warehouses to administer vaccines to its 800,000 logistics workers.

But why are Hospitals going bankrupt?

In 2020, we’ve seen record healthcare bankruptcies. Yes, healthcare. The same industry expected to win this battle for us.

By October 2020, over 47 hospitals filed for bankruptcies. We know why the hospitality industry is getting crushed but why hospitals? This is critical infrastructure. It is a combination of lower patient volumes and canceled elective procedures. Less revenue and more expenses is a recipe for disaster. Hospitals are now in a cash crunch.

Even with $275 billion in stimulus and emergency loans, the government was not able to hold off the wave of healthcare bankruptcies. The AHA expects the health system losses to surpass $300 billion in 2020 alone. I suspect these losses will continue in 2021 as well.

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